Poisons

Question 1

ACETAMINOPHEN (antidote)

Answer 1

N-ACETYLCYSTEIN

Question 2

ANTICHOLINERGICS (antidote)

Answer 2

PHYSOSTIGMINE

0.02 mg/kg over 5 min; may repeat q5-10 min to 2 mg max

Question 3

BENZODIAZEPINES (antidote)

Answer 3

FLUMAZENIL

0.2 mg over 30 sec; if response is inadequate, repeat q1min to 1 mg maX

Question 4

BETA BLOCKERS (antidote)

Answer 4

GLUCAGON

0.15 mg/kg bolus followed by infusion of 0.05-0.15 mg/kg/hr

Question 5

CALCIUM CHANNEL BLOCKER (antidote)

Answer 5

INSULIN

1 unit/kg bolus followed by infusion of 0.5-1 unit/kg/hr

Question 6

CARBON MONOXIDE (antidote)

Answer 6

OXYGEN

0.02 mg/kg over 5 min; may repeat q5-10 min to 2 mg ma)

Question 7

CYANIDE (antidote)

Answer 7

HYDROXOCOBALAMIN (CYANOKIT)

70 mg/kg (adults: 5 g) given over 15 min

Question 8

ETHYLENE GLYCOL, METHANOL (antidote)

Answer 8

FOMEPIZOLE

15 mg/kg load; 10 mg/kg q12h × 4 doses; 15 mg/kg q12h until ethylene glycol level is <20 mg/dL

Question 9

IRON (antidote)

Answer 9

DEFEROXAMINE

Infusion of 5-15 mg/kg/hr (max: 6 g/24 hr)

Question 10

ISONIAZID (antidote)

Answer 10

PYRIDOXINE

Question 11

LEAD and other HEAVY METALS (antidote)

Answer 11

BAL (dimercaprol)

CALCIUM DISODIUM EDTA

DIMERCAPTOSUCCINIC ACID (SUCCIMER, DMSA, CHEMET)

Question 12

METHEMOGLOBINEMIA (antidote)

Answer 12

METHYLENE BLUE, 1% SOLUTION

Question 13

OPIOIDS (antidote)

Answer 13

NALOXONE

Question 14

ORGANOPHOSPHATES (antidote)

Answer 14

ATROPINE

0.05-0.1 mg/kg repeated q5-10 min as needed

PRALIDOXIME (2-PAM)

25-50 mg/kg over 5-10 min (max: 200 mg/min); can be repeated after 1-2 hr, then q10-12h as needed

Question 15

SALICYLATES (antidote)

Answer 15

SODIUM BICARBONATE

Bolus 1-2 mEq/kg followed by continuous infusion

Question 16

SULFONYLUREAS (antidote)

Answer 16

OCTREOTIDE and DEXTROSE

Question 17

TRICYCLIC ANTIDEPRESSANTS (antidote)

Answer 17

SODIUM BICARBONATE

Question 18

In US, most common cause of acute liver failure and leading cause of intentional poisoning death

Answer 18

ACETAMINOPHEN

Question 19

Acetaminophen
single toxic dose in children

Answer 19

> 200mg/kg

Question 20

Acetaminophen
single toxic dose in adolescents and adults

Answer 20

> 7.5g - 10g

Question 21

SALICYLATE
Acute toxic dose

Answer 21

> 150mg/kg

Question 22

SALICYLATE
more significant toxic dose

Answer 22

> 300mg/kg

Question 23

SALICYLATE
Severe, potentially fatal, toxicity

Answer 23

> 500mg/kg

Question 24

NSAIDS, IBUPROFEN
toxic dose

Answer 24

> 400mg/kg

Question 25

Symptoms of CHOLINERGIC EXCESS at MUSCARINIC RECEPTORS

Answer 25

DUMBBELS
diarrhea/ defecation
urination
miosis
bronchorrhea/bronchospasm
bradycardia
emesis
lacrimation
salivation

Nicotinic signs and symptoms
muscle weakness
fasciculation
tremors
hypoventilation (diaphragm weakness)
hypertension
tachycardia
dysrhythmias

Severe manifestations: coma, seizures, shock, arrhythmias, and respiratory failure.

Question 26

dose in Moderate to Severe IRON TOXICITY

Answer 26

> 60mg/kg

Question 27

Refer to medical care if with ingestion of this dose of elemental iron

Answer 27

> 40mg/kg